- Molina Healthcare (Albany, NY)
- …functionality through project inclusion and documentation review to understand proper claims processing for the applicable solution. Validates data received ... support issues related to EDI transaction editing and custom claims processes to determine root cause of issue. Gains...claims to identify billing issues that will impact claims processing and payment. Monitor new solutions implemented to… more
- Molina Healthcare (Albany, NY)
- …Maintains critical provider information on all claims and provider databases. Synchronizes data among multiple claims systems and application of business ... rules as they apply to each database. Validate data to be housed on provider databases and ensure...and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality. +… more
- Trinity Health (Troy, NY)
- **Employment Type:** Part time **Shift:** Day Shift **Description:** ** Sr . Registration Associate - Troy, NY - PART TIME** **_(3 days per week with required ... If you are looking for a position as a Sr . Registration Associate, this could be your opportunity. Here...- Friday Office Hours What you will do: The Senior Registration Associate is responsible for performing and overall… more
- Molina Healthcare (Albany, NY)
- …more affordably. Performs research, financial modeling, and analysis of complex healthcare claims data (medical, pharmacy and ancillary) to deliver practical, ... **Job Description** **Job Summary** Sr . Analyst, Network Strategy, Pricing & Analytics guides...(including trend analysis) by utilizing NetworX Modeler and ETL systems to support negotiating strategies, modeling current and future… more
- Molina Healthcare (Albany, NY)
- … systems to support executive decision-making + Mine and manage information from large data sources + Analyze claims and other data sources to identify ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst, Medical Economics provides support and consultation...reports, and improvement opportunities based on analyses + Provide data driven analytics to Clinical COE, Finance, Claims… more
- Ducommun (Coxsackie, NY)
- Sr . Human Resources Generalist Provides full range of support in all areas of HR including recruiting, benefits administration, employee relations, training, ... development, orientation, data administration and documentation, talent management, HR compliance, and all related activities. Internal Communication and… more
- Evolent (Albany, NY)
- …manner that fosters expertise and cooperation.** **Process and validate raw unadjudicated claims data .** **Use programming skills to explore, examine and ... **Familiarity with value-based care and utilization management- Preferred.** **Understanding of data systems and the critical thinking skills to solve… more
- Evolent (Albany, NY)
- …care/service + Familiarity with value-based care and utilization management + Understanding of data systems and the critical thinking skills to solve new ... activities as well as Product Development efforts. **What You'll Be Doing:** + Analyse claims and authorization data to identify trends, calculate cost of care,… more
- Molina Healthcare (Albany, NY)
- … claims databases. Maintains critical information on claims databases. Synchronizes data among operational and claims systems and application of ... business rules as they apply to each database. Validate data to be housed on databases and ensure adherence...information into the claim payment system and other applicable systems . + Participates in defect resolution for assigned component… more
- Molina Healthcare (Albany, NY)
- **JOB DESCRIPTION** **Job Summary** Performs research and analysis of complex healthcare claims data , pharmacy data , and lab data regarding network ... + Healthcare Analyst I or Financial/Accounting Analyst I experience desired + Multiple data systems and models + BI tools To all current Molina employees: If you… more
- Intermountain Health (Albany, NY)
- …in support of Intermountain Health's key strategy of Expanding Proactive Care. As a Data Analyst-Technical- Senior , you will act in a more senior capacity, ... to strategic initiatives, clinical standards, and operational goals through data insights. Reporting to senior leaders in...or economics and four years of relevant experience performing data analysis. + SQL + Insurance claims … more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- **Position Summary** The Senior Manager of Field Technology will lead the design, optimization, and delivery of field sales reporting platforms and tools. This role ... in ensuring that our field teams have seamless access to accurate, actionable data to drive performance. The role focuses on managing field-facing technology … more
- Elevance Health (Latham, NY)
- … data mining, entity review, law enforcement referral, and use of proprietary data and claim systems for review of facility, professional and pharmacy ... **Investigator Senior ** **Supports the Payment Integrity line of business**...to recover corporate and client funds paid on fraudulent claims . Health insurance experience required with understanding of health… more
- General Dynamics Information Technology (Menands, NY)
- …the GDIT's office at Riverview Center in Menands, NY. As a software Test Engineer Senior supporting the eMedNY Systems Integration Team, you will be trusted to ... Language (SQL) **Experience:** 5 + years of related experience **Job Description:** Senior Software Test Engineer (Manual) Seize your opportunity to make a personal… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …Under the direction of the Director/Associate Director of Clinical Management, the Senior Clinical Study Manager is responsible for the oversight and management of ... assigned trial(s), as assigned.** **Participates in ongoing review of clinical trial data focusing on data integrity, trending and consistency.** **Supports… more
- Walgreens (Loudonville, NY)
- …by Pharmacy Manager, Staff Pharmacist and Store Manager including utilizing pharmacy systems to enter patient and drug information, ensuring information is entered ... the pharmacist, including those to physicians. Processes (corrects and resubmits) manual claims for third party program prescription services in a timely and… more
- Highmark Health (Albany, NY)
- …overall business targets or assigned volume of new applications or RFP's.Utilize various systems and tools to obtain necessary data and accurately complete and ... quotes and analyzes the structure of a contract for a group based on claims experience, characteristics of the employee groups, etc. The incumbent uses discretion of… more
- Otsuka America Pharmaceutical Inc. (Albany, NY)
- …- Interacts effectively with internal/external functional business units to gather data and develop documentation required for on-time submissions. - Works closely ... (Word, Excel, PowerPoint, Outlook) and familiarity with electronic document management systems (EDMS). **Competencies** See OPDC Competencies Chart (Level X) **P**… more
- Fujifilm (Albany, NY)
- **Position Overview** The accomplished Senior Corporate Compliance Specialist will support FUJIFILM's Corporate Compliance Program's operations to ensure high ... and implementation of new or updated polices, procedures, or systems to address new risk areas or to improve...action plans, and prepare related reports. + Manage transparency data collection, validation, and reporting process to ensure compliance… more
- Highmark Health (Albany, NY)
- …years with coding languages, analytical software, systems , tools and processes using claims , clinical, enrollment and provider data + 3 years of project ... times per year for scheduled business meetings.** This job creates data -driven insights which identify actionable opportunities and/or create analytics and reporting… more